People with Learning Disabilities (Abuse)

Debate between Fiona Mactaggart and Paul Burstow

Monday 3rd September 2012 Commons Chamber

[Paul Burstow]

My hon. Friend makes an important point and anticipates what I am about to say. The Department’s guidance is clear. People should be supported to live in the community, wherever possible, and only in strictly limited cases should assessment and treatment centres be used. Nowhere in policy or guidance is there justification for long-stay assessment and treatment hospitals. Indeed, the CQC found length of stay ranging from anything between six weeks and 17 years, with five to seven years not uncommon.

The hon. Member for Slough (Fiona Mactaggart) raised the issue of data during her intervention on the right hon. Member for Coatbridge, Chryston and Bellshill. I agree that we need to improve data collection so that we have a clearer picture of what is going on. The painstaking work of the serious case review, Department of Health officials and others to create a clear picture of the system begs questions about the adequacy of data collection for many years.

[Fiona Mactaggart]

I wrote to the hon. Gentleman last week—although, having been a Minister, I suspect that he has not seen my letter—asking him to conduct an audit of out-of-area placements of vulnerable people and to publish the figures on people who are placed a long way away from home. Will he commit tonight to do that?

[Paul Burstow]

What I will rightly do—having been a Minister, the hon. Lady will understand this—is give her the justice of reading her letter and considering properly what she has asked. There is merit in what she has said. There is certainly merit in ensuring that those who commission such services are collecting that information so that they have a clear picture of those who are being placed out of area.

I am more interested in the more fundamental question of the appropriateness of something that is outside of policy becoming a practice and being established as an ongoing practice. My point is that we need to look critically at the system that has allowed out-of-area placement to grow to the extent that it has, which has allowed such abuse to go unnoticed in some places for too long. There is no place for such long-stay institutions detaining vulnerable people far away from home.

Providers, commissioners, regulators and individual professionals all have a responsibility—a duty of care to those on whose behalf they commission services. Last year, in the wake of Winterbourne View, the CQC conducted 150 inspections of other services for people with learning disabilities. It adopted new ways of working involving experts both by profession and experience. Although the CQC found no other cases of abuse like those exposed at Winterbourne View, it is disturbing that half of the services that the CQC inspected revealed evidence of poor quality care that was failing to meet essential care and safeguarding standards. Everyone who is involved across the NHS and social care has a vital part to play in driving up standards.

As I have said, the Department’s guidance has been and remains clear. The interim report sets out clearly the elements of the model of care that we expect to see commissioned. However, that is not always happening on the ground. Those commissioning, or in too many cases, spot purchasing, long-stay assessment and treatment services need to look carefully at what they are doing. Indeed, I can tell the right hon. Member for Coatbridge, Chryston and Bellshill that the chief executive of the NHS Commissioning Board and the Department’s director-general of social care wrote to chief executives and chairs of all NHS bodies and local authorities to highlight the interim report and reinforce their responsibility to improve commissioning.

When I published the interim report in June, I set out five objectives for improving services for people with learning disabilities and behaviour that challenges. Those objectives underpin the 14 national actions set out in the report to improve care and support for people with learning disabilities or autism and behaviours that challenge. Those actions include promoting open access for families and visitors and ensuring that people are involved in reviewing the care that they receive; encouraging the CQC to carry out unannounced inspections at any time of the day and week; working with the CQC and the Department for Education to promote best practice and positive behavioural support and ensure that physical restraint is only ever a last resort, and certainly not a tool of choice as it clearly was at Winterbourne View; improving integration between the NHS and social care by setting up health and wellbeing boards to agree joined-up ways of improving services; and getting a range of national organisations, including the Association of Directors of Adult Social Services, the Royal College of General Practitioners and other royal colleges, the NHS Confederation and the NHS Commissioning Board, to sign up to a concordant setting out the actions that each will be committed to taking forward to deliver the right care for people with learning disabilities and challenging behaviour.

One final action that I commend to the House is our work with the NHS Commissioning Board to improve the use of NHS contracts. When we read the serious case review, it is shocking to see how few NHS organisations used NHS contracts to contract their services. They used Castlebeck’s own contract, which was a poor document. The serious case review is just part of what we need to examine. There is also the NHS review of commissioning that was conducted by the South West strategic health authority, which sets out a number of other actions that are being taken to address failings.

I made it clear when we published the interim report that I would very much welcome feedback on it to ensure that the final report, and the action plan that we will publish alongside it, would be as robust as possible and deliver what Members of all parties wanted. I therefore welcome the report by Mencap and the Challenging Behaviour Foundation. As part of our response, we will consider the role of commissioners and how we can support them in the new health and care system.

In addition to the work that my Department is doing directly in response to Winterbourne View, we are taking a number of other steps to improve the care and support system. For example, we are introducing the first ever code of conduct and national minimum training standards for health care and adult social care support workers. That goes to a point that was made in interventions. That work is being taken forward by Skills for Care and Skills for Health and will ensure, for the first time, that employers and people who provide care understand their responsibilities and roles in delivering high-quality and acceptable care to people who need it.

In July, when we published the White Paper on care and support, we set out plans for measures to increase the availability of appropriately skilled care workers, including by expanding the number of care apprenticeships. The White Paper also made the case for strengthening safeguarding, which is what this debate is fundamentally all about. That is a key priority for the Government.

We are committed to preventing, and reducing the risk of, significant harm to adults in vulnerable situations, while supporting individuals to maintain control over their own lives and to make informed choices without coercion. That is why the draft Care and Support Bill sets out a new statutory framework for adult safeguarding to address some of the defects that have been identified, and key responsibilities for local authorities and their partners in the NHS and the police. It will ensure that safeguarding adults boards exist everywhere in England. The Bill will place all that on a statutory footing for the first time.

I am grateful to the right hon. Member for Coatbridge, Chryston and Bellshill for securing the debate. In learning the lessons from Winterbourne View, I am determined to ensure that the voices of people with learning disabilities and of families are right at the heart of what we do.

The National Forum of People with Learning Disabilities and the National Valuing Families Forum sit on the programme board that I chair, which will oversee progress on the action plan. Both have key roles to play locally and nationally in driving change.

Let me end by making it clear that the Government’s approach to people with learning disabilities is grounded in fundamental principles of human rights, independence, inclusion and choice. There can be no excuses. There is no tolerance of those who abuse disabled people.

The right hon. Gentleman has done the House a service by bringing these matters to it tonight. I look forward to coming back to the House later this year with the final report setting out the actions that the Government will take to stamp out abuse.

Question put and agreed to.

Winterbourne View Care Home

Debate between Fiona Mactaggart and Paul Burstow

Tuesday 7th June 2011 Commons Chamber

[Paul Burstow]

I think I will say yes to that, but I want to make it clear that I am not answering in the context of hypotheticals. I do not know the conclusions of the exercise, and Ministers who come to the Dispatch Box and promise that things will never happen again are all too often and too soon proven wrong. We must make sure that we do everything we can to learn lessons from this to minimise the risks in the future, and we need to make sure that responsibility and accountability are at the heart of the reforms that the Government are making to health and social care.

[Fiona Mactaggart (Slough) (Lab)]

The Minister is right to say that we need to learn lessons from this, but how long will it take us? The CQC has admitted inspecting Winterbourne View three times in the past two years. The South Gloucestershire safeguarding board was informed in October, but apparently took no action before the programme was aired on television. This is not the first such scandal. When I was first elected, one of the first things I did was to persuade the Department of Health to commission the Bergner report into the Longcare home scandal on the borders of my constituency —a similar huge institution in which residents were raped, abused and tortured by the people who were given care of them. It seems to me that it is not just the individual institutions but Government who need to learn the lesson. How much money is the Minister putting into advocates and listeners of the volunteer kind mentioned by my right hon. Friend the Member for Croydon North (Malcolm Wicks), or of the professional kind, so that the voices of those who cannot always speak for themselves are heard in the inspection process?

[Paul Burstow]

I mentioned in my statement that each of the individuals who have been affected in this terrible way have advocates. The hon. Lady makes an important point about the role that advocacy plays for those who lack capacity or the ability in certain circumstances to advocate on their own behalf. We are looking at that as part of the overall reforms of health and social care, but as for a precise sum of money, I do not have a figure in my head that I can give her now. I will write to her on that point.